Enhancing a statewide trauma network: Application of suicide prevention best practices in urban and rural emergency departments

Background/Purpose: Suicide is a significant problem in Hawai‘i. It is the single leading cause of fatal injuries among Hawai‘i residents ages 15 to 74. Trauma centers and emergency departments (EDs) are often the first stop when a youth is suicidal or attempts suicide, and thus are well-situated to offer prevention and intervention services to youth and families. The aim of the “Enhancing the Statewide Trauma Network” project is to develop community networks of healthcare providers and community members who share the same knowledge and language related to suicide prevention. Methods: An evidence-based training program, using a train-the-trainer model, has been implemented at EDs statewide (10 currently enrolled, 13 forthcoming). Pre/post surveys are conducted to assess trainees' knowledge of suicide prevention and comfort level in intervention strategies. In addition, screening and referral protocols are being developed and implemented at these sites. Results: Training feedback from participants indicated they increased their knowledge and skills in suicide prevention, and felt the training met the needs of their organizations. Seven sites are now screening for suicide risk. The three other sites' screening questions were minimal or absent altogether, so project staff have been assisting with protocol development. Discussion/Conclusions: Application of the evidence-based training program, as well as the train-the-trainer model, resulted in increased suicide prevention knowledge and capacity among ED-based healthcare professionals. Such trainings were also a facilitator to establish/strengthen screening protocols in the EDs, which will lead to earlier intervention of at-risk youth and prevent later, more acute suicidal behaviors.